To be a Negro in this country and to be relatively conscious is to be in a state of rage almost all of the time—and in one’s work. And part of the rage is this: It isn’t only what is happening to you. But it’s what’s happening all around you and all of the time in the face of the most extraordinary and criminal indifference—the indifference of most white people in this country—and their ignorance.
Now, since this is so, it’s a great temptation to simplify the issues under the illusion that if you simplify them enough, people will recognize them. I think this illusion is very dangerous because, in fact, it isn’t the way it works. A complex thing can’t be made simple. You simply have to try to deal with it in all its complexity and hope to get that complexity across.4
Living life in that manner can never be healthy, no matter what anyone says to the contrary. The experience of constantly navigating indifference leaves those of us in the Black community seeking a sense of closure we know may never come. Just as in an abusive relationship, you seek validation from the very person who is hurting you and experience extreme isolation, exhaustion, and anger. The complexity of a puzzle that seems as though it should be solvable, but has infuriatingly been posed as a low-stakes game of your own making, also creates a sense of hopelessness, where your concerns are dismissed even though the weight of them is literally crushing you alive. The resulting impact has huge mental health implications that have continued to plague our community generation after generation and manifest in the anxiety, depression, and feelings of hopelessness that many in our Black communities feel, particularly the matriarchs of most communities—Black women.
There are, however, those working tirelessly to address these issues. One such individual is Tamika Lewis, the Founder and CEO of WOC Therapy, Inc. Her organization takes a trauma-informed, culturally competent approach to working with clients. Her practitioners teach clients how to reprogram painful past learning by getting to the source of limiting thoughts and beliefs. They also encourage clients to ask more generative questions, such as “What happened to me?” instead of “What’s wrong with me?” In addition, her practice explores historical and institutional racism and its impact on mental health in BIPOC communities. As a master’s-level trained social worker and mental health expert, she draws from over fifteen years of experience working with agencies such as UCLA Medical Center, DCFS, and Children’s Hospital of Los Angeles, with an extensive background in educational counseling specializing in working with teens and women.
In her 2021 article on Black women and depression, she discusses the significant health issues faced in the US. One of the most prevalent of these issues is mental illness. This is especially true within the African American population, where major depressive disorder (MDD) is particularly common. Though there has been an increase in awareness, there are still major hurdles we need to face.
In a recent large-scale national survey, a lifetime prevalence rate of 10.4 percent was reported for depression among African Americans.5 This suggests that depression affects African Americans at a high rate. The data also showed that African Americans are more likely to have feelings of sadness, worthlessness, and hopelessness than white Americans. That’s well over four million Americans who are faced with psychiatric symptoms and conditions.
It is well-known that unfair laws, policies, and practices have had a significant negative impact on African Americans for the entire history of the United States. Though times have changed, African Americans are still suffering from these laws and policies. There are still a lot of aspects of the Black experience that are damaging, both mentally and physically. No one understands this more than the average African American woman. They are among the most discriminated-against groups in the US, and are often forced to handle and navigate harsh and hostile situations and environments. Racism, sexism, colorism, and even xenophobia are all causes of stress and MDD, and this has been the truth for centuries.
What’s most alarming about MDD among historically excluded communities is the lack of support and resources. Due to the stigma surrounding psychiatric disorders, many African American women don’t actively seek treatment for symptoms. Instead of therapy, self-care, or antidepressants, they turn to poor coping habits and mechanisms. There is also a huge lack of representation within the field of study for mental well-being, so it’s much harder to connect to therapists and doctors, or to even find WOC therapists.
As mentioned before, African Americans have problems when it comes to seeking help for MDD or any similar condition. African American depression statistics from the CDC reported that African American women are 4 percent more likely to have symptoms of MDD than whites, and are less likely to report it or seek treatment. One of the major problems is a lack of representation; because there are few African American counselors, it’s hard for African American women to build trust in therapy care. Another issue is the mistrust of antidepressants and similar medications.
Post-traumatic stress disorder (PTSD) and MDD are both serious mental health conditions, but they differ significantly in their causes and symptoms. MDD is a condition characterized by overwhelming feelings of sadness, hopelessness, and worthlessness, which can affect your daily life in many ways. It can cause insomnia, memory loss, unhealthy weight loss, an increase in heart problems, a weakened immune system, dietary issues, and so on. It can happen to anyone, and episodes can strike at any moment without warning.
PTSD is a condition that develops from a traumatic experience, and can cause chronic pain and fatigue, panic attacks, social isolation, heart disease, social anxiety, eating disorders, and many other effects. In contrast to MDD, PTSD episodes can still occur at any time when a memory or feeling of a traumatic event or experience triggers them.
Due to the harsh reality that women of color face on a day-to-day basis, having MDD and PTSD is far more likely for them than for their male counterparts. Yet Black women’s mental health remains a widely ignored issue.6
During my time hosting the Black Power Moves podcast on the EBONY Covering Black America Podcast network, I met and interviewed several psychiatrists and psychologists to learn more about the unique mental health challenges faced in the Black community. There are multiple compounding issues that lead to a lack of awareness and care, which include the stigma of mental health illness, a lack of access to resources, and the difficulty of finding therapists who look like us, let alone have cultural awareness of racial trauma and its effects.
In the next chapter, we’ll delve further into some of these challenges, and how to consistently practice self-care in a way that helps us embrace ancestral knowledge in combination with evidence-based traditional strategies.
journaling questions 
1.How have you worked to prioritize yourself in your daily life, and what challenges have you encountered? How do you balance the needs of others with your own needs for self-care and healing?
2.Can you describe your personal journey to healing and self-discovery? What have been some pivotal moments, lessons learned, or obstacles overcome along the way?
3.How do you recognize when you need rest, and how do you honor that need? How does rest fit into your overall perspective on self-care and well-being?
4.In what ways have you explored or integrated ancestral knowledge into your self-care practices? How has tapping into this wisdom influenced your approach to healing?
5.How do you recognize and address racial trauma in your life? What supports or resources have been essential in acknowledging and healing from these experiences?
6.How have you come to understand the importance of mental health care in your life? What actions have you taken to ensure that your mental health needs are being met?
7.How does your community influence or support your healing journey? What role do relationships play in your overall wellness and your ability to prioritize yourself?
8.How do you view personal growth and transformation in the context of healing and self-care? What practices or strategies have been particularly transformative for you?
9.How do you see the intersection of your identity as a Black woman impacting your mental health and self-care needs? How do you navigate the unique complexities this intersectionality may present?
10.How do you approach wellness in a holistic way, considering not only mental health but also physical, spiritual, and emotional aspects? How does this approach contribute to your overall sense of well-being and your journey toward healing?
affirmations 
1.I value and prioritize myself, recognizing that my well-being is essential. I am worthy of time, care, and attention.
2.I am committed to my healing journey, embracing each step with courage and openness. I grow stronger and more self-aware every day.
3.I honor my body’s need for rest, understanding that it is not a sign of weakness but a vital part of my self-care and rejuvenation.
4.I connect with the wisdom of my ancestors, allowing their strength and insight to guide my self-care and healing practices.
5.I acknowledge the racial trauma I have experienced, and I am empowered to heal. My experiences shape me, but they do not define me.
6.I recognize the importance of mental health care and take proactive steps to nourish my mental well-being. I seek support when needed, knowing it’s a sign of strength.
7.I embrace the support of my community, knowing that connection and mutual care enhance my journey to well-being.
8.I celebrate my growth and transformation, knowing that each step forward is a victory on my path to healing and self-discovery.
9.I honor the unique aspects of my identity as a Black woman, recognizing that my self-care must be responsive to my specific experiences and needs.
10.I approach my well-being holistically, nurturing my mental, physical, spiritual, and emotional health. Each aspect is vital to my overall wellness and joy.
2.Gray, Sara. 2021, “Deeply Rooted in Black History—National Equity Project.” National Equity Project. www.nationalequityproject.org/blog/black-historys-deep-roots.
3.“Post Traumatic Slave Syndrome,” n.d., Dr. Joy DeGruy. Accessed June 26, 2023. www.joydegruy.com/post-traumatic-slave-syndrome.
4.Baldwin, James. 2020. “ ‘To Be In A Rage, Almost All The Time’: 1A.” NPR. www.npr.org/2020/06/01/867153918/-to-be-in-a-rage-almost-all-the-time.
5.Ward, Earlise C., Jacqueline Wiltshire, Michelle A. Detry, and Roger L. Brown, 2013. “African American Men and Women’s Attitude Toward Mental Illness, Perceptions Of Stigma, And Preferred Coping Behaviors.” Nursing Research (62), 3:185–194. doi.org/10.1097/nnr.0b013e31827bf533.
6.Lewis, Tamika. 2021. “Black Women and Depression.” WOC Therapy. woctherapy.com/black-women-and-depression.
chapter 3
the prevalence
of mental illness
in the Black
community
“Mental Health is our ‘silent’ crisis. There is no shame in speaking out and seeking help.”
—Viola Davis
